Validity of single-item screening for limited health literacy in english and Spanish speakers

W.P. Bishop, S.J. Craddock Lee, C.S. Skinner, T.M. Jones, K. McCallister and J.A. Tiro

American Journal of Public Health, 2016, vol. 106, issue 5, 889-892

Abstract: Objectives. To evaluate 3 single-item screening measures for limited health literacy in a community-based population of English and Spanish speakers. Methods. We recruited 324 English and 314 Spanish speakers from a community research registry in Dallas, Texas, enrolled between 2009 and 2012.We used 3 screening measures: (1) How would you rate your ability to read?; (2) How confident are you filling out medical forms by yourself?; and (3) How often do you have someone help you read hospital materials? In analyses stratified by language, we used area under the receiver operating characteristic (AUROC) curves to compare each item with the validated 40-item Short Test of Functional Health Literacy in Adults. Results. For English speakers, no difference was seen among the items. For Spanish speakers, "ability to read" identified inadequate literacy better than "help reading hospital materials" (AUROC curve = 0.76 vs 0.65; P = .019). Conclusions. The "ability to read" item performed the best, supporting use as a screening tool in safety-net systems caring for diverse populations. Future studies should investigate how to implement brief measures in safety-net settings and whether highlighting health literacy level influences providers' communication practices and patient outcomes.

Keywords: adult; clinical study; controlled study; doctor patient relation; health literacy; hospital; human; language; receiver operating characteristic; register; safety; screening; United States; validity; adolescent; aged; female; health literacy; Hispanic; language; male; middle aged; questionnaire; reading; reproducibility; standards; statistics and numerical data; Texas; young adult, Adolescent; Adult; Aged; Female; Health Literacy; Hispanic Americans; Humans; Language; Literacy; Male; Middle Aged; Reproducibility of Results; ROC Curve; Surveys and Questionnaires; Texas; Young Adult (search for similar items in EconPapers)
Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2016.303092_4

DOI: 10.2105/AJPH.2016.303092

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